Reconstructing the Meaning Effect-The Capacity to Self-Heal Emerges From Placebo Concept incl. CFS

[Dolphin]

Free full text: http://ojs.statsbiblioteket.dk/index.php/sygdomogsamfund/article/download/22897/20019

Reconstructing the Meaning Effect - The Capacity to Self-Heal Emerges

From the Placebo Concept

Harald Walach

European University Viadrina walach@europa-uni.de

Walach, H. (2015). Reconstructing the Meaning Effect - The Capacity to Self-Heal Emerges From the Placebo Concept, Tidsskrift for Forskning i Sygdom og Samfund, nr. 23, 111-139

 

[Dolphin]

For what it's worth, this has a section on CFS:

The context is often not constructed by the therapist or the study alone, but also by the patient. This is commonly termed faith or belief. This can be nicely seen in our study on distant healing (Walach et al., 2008). We enrolled 409 patients with severe chronic fatigue syndrome into a study of distant healing. They either received distant healing immediately by three healers unknown to them and without any contact, or they had to wait for their treatment for six months. Again, half of the patients were informed about the group allocation, such that we had patients who were treated and knew about it, patients who waited and knew about it, and patients who were either treated or had to wait and did not know it. The overall result of the study did not provide any evidence that distant healing had an effect, except that all those groups that were either treated or did not know about their allocation had about one third of a standard deviation improvement over the control group that knew they had to wait for treatment. But the more interesting finding was the discovery that about 8%, 35 patients in all, had strong improvements. Analysing all those patients’ improvement that also provided data after a one year follow-up revealed that the decisive variable was not whether they were treated but whether they believed they were treated and received healing, whether true or wrong was irrelevant. Effect sizes were large and approached a standard deviation (d = 0.95). A qualitative post-hoc study using interviews revealed that most of these patients had made a leap of faith and at some point started to believe that something would happen (Güthlin, Anton, Kruse, & Walach, 2012). Thus, important parameters might reside in the patient’s consciousness. It is the meaning that triggers the meaning response.

I imagine these are self-report measures. Some people saying on one or more questionnaires they feel a bit better because they believe they are having a therapy is a lot different from the same number having objective improvements. Also, some results can change over time for all sorts of unconnected reasons.

 

[Roy S]

the decisive variable was not whether they were treated but whether they believed they were treated and received healing,

 

[TiredSam]

I just can't keep up with all this. I need to go and lie down again.

 

[sarah darwins]

Thus, important parameters might reside in the patient’s consciousness. It is the meaning that triggers the meaning response.

Awesome. Wonder if it means anything? I'm thinking not.

 

[duncan]

Reads smug, somehow. Like they were impressed with their own profundity. I got really good in high school annoying my teachers with a similar tone.

Do they qualify "strong improvements"? What is the scale? So 92% did NOT have a strong improvement? Would it be fair to qualify 92% as the overwhelming majority? So the "analyzing all those patients" reduces to analyzing the very few who reported meaningful improvement. Could be 8% of respondents just felt badly for the people running the study, and tried to throw them a bone....

 

[Cheshire]

But the more interesting finding was the discovery that about 8%, 35 patients in all, had strong improvements.

8% of patients that accepted to participate in such a loosy study, what conclusion can one draw from that?

 

[barbc56]

I wonder if the group that had strong improvements, really had me/cfs?

Barb

 

[worldbackwards]

I wonder if the group that had strong improvements, really had me/cfs?

Barb

Yeah, it's a bit like the "take up thy bed and walk" crowd from the Lightning Process, isn't it.

 

[Snow Leopard]

I imagine these are self-report measures. Some people saying on one or more questionnaires they feel a bit better because they believe they are having a therapy is a lot different from the same number having objective improvements. Also, some results can change over time for all sorts of unconnected reasons.

Right, this study shows that self-report measures can be strongly biased in the absence of an underlying treatment effect.

If this wasn't published in an obscure journal, I'd probably write a Pubmed comment... Sigh.